Minor injuries and Ibruprofen...

MIA

Just wondering if any health & fitness guru's can clear something up for me...

I was always under the impression that if you got a ligament/muscle injury the appropriate treatment is R.I.C.E plus to take ibruprofen for a day or two. But is the purpose of the ibruprofen to help with the pain or does it aid the healing process??? I always thought it did both but am not sure...

MIA

Ibuprofen is an antiinflammatory, with some analgesic properties, as with other NSAIDs (non steroidal anti inflamatories) it requires a certain amount of time to build up in your system to have maximum effect.

It is also far more effective when taken with, or in a preperation that contains paracetamol.

also available in sarcastic

Philosophy is questions that may never be answered. Religion is answers that may never be questioned.

LE

AFAIK Ibuprufen is an anti-inflammatory drug as well as a pain killer so it does help the healing process by stopping or at least reducing swelling. Which in turn reduces the possiblity of tissue damage around the injury site.

Doctors/medic/knowitalls please feel free to critique as necessary

Specifically, I will discuss acute inflammation, which is the initial response to tissue injury (such as an ankle sprain). There is also chronic inflammation, often associated with diseases such as rheumatoid arthritis, that occurs with a different time course and involves different cellular and chemical mediators than the acute variety. During the acute inflammation that results following an injury, blood flow to the affected area increases as a result of vessel dilatation. Not only do the blood vessels dilate, they become leaky, allowing proteins from the blood to spill out of the vessels and into the surrounding tissues. Grossly, the effects of this leakiness are observed as swelling or edema near the site of injury. White blood cells, or leukocytes, are heralded to the site of injury (a process referred to as chemotaxis), traveling first in the bloodstream and then, leaving the circulation by migrating through vessel walls. Leukocytes are the major effectors of inflammation. During an infection, they are capable of engulfing microbes using a process known as phagocytosis. In addition, they are capable of releasing a host of chemicals that can damage tissues. One family of chemicals that leukocytes, as well as some other cell types, release during acute inflammation is called prostaglandins. Prostaglandins are synthesized in and released from the leukocytes. In general, prostaglandins function to dilate blood vessels and promote leakiness. To make prostaglandins, leukocytes use a compound known as arachidonic acid as a starting material, and convert it into prostaglandins through the action of an enzyme called cyclooxygenase. NSAIDs, including aspirin and ibuprofen, work by inhibiting cyclooxygenase activity, thus reducing prostaglandin synthesis. With less prostaglandins around, there is less inflammati

MIA

Good post Steven!!! Afraid I lost you after leukocytes, prostaglandins and cyclooxygenase!!!!

Ok so ibruprofen reduces inflammation. But in my non-medical understanding I would have thought inflammation of an injury would be a good thing??? Inflammation = more blood flow = more nutrients and stuff for healing?

LE

Can only help with results of I'profen with arthritis-sort of pain. Two x 600mg per day keeps quite severe pain at bay. Also good is a thing called MSM cream which stops - it seems to me when I use it - almost all sorts of pain that get past I'profen and prescription pain killers.

Crow

Just a note - NSAIDs have been shown to decrease the rate of soft tissue healing. The inflammation, though painful, is a functional response. By inhibiting this, you thus delay healing. If you can get away with complete rest that is obviously the ideal, avoiding NSAIDs if possible. But if you have to plod on, take some.

Clanker

"There are 5 classic signs of soft tissue inflammation, redness, swelling, warmth,pain and impaired function. The redness and swelling are due to increased circulation (hyperaimia) that typically occurs a few minutes after suffering an injury...The pain and swelling nhibit normal movement and function. One of the Main objectives at this stage is to control the inflammation. An excessive period of inflammation is NOT conducive to ideal repair. Prolonged increased vascular activity and teh resultant swelling in and around the damaged tissues impede the rate of eaarly repair and increases the amount of secondary hypoxic death of previosly undamaged cells. adjacent to the injury site." Hope that helps

Clanker

Just to confuse you all - inflammation is a result of injury but it is also a necessary part of repair. Without inflammation to start off the process, a good, strong, healthy repair is less likely. Some medical research is now advocating delayed use of NSAIDs to allow for 48hrs of healing then taking NSAIS to resolve EXCESSIVE inflammation and swelling. In addition, some NSAIDS has been shown to delay wound healing and bone healing but have no adverse effect on ligament healing.

Hard to know what to do eh? I recommend using simple pain killers ( like paracetamol ) for first 48 hours and using Ice, Rest & elavation. if at 48hrs lots of swelling and pain remains - start NSAIDs. However your Doc my have other ideas and I know a Pharmacist that hates it when I give that advice......

Also if injury still a significant problem after couple of days - get referred to a physio. They'll sort it out for you and make sure you build up fitness properly.

Clanker

As mentioned a few times, inflammation is a functional response to injury, necessary in the physiology of healing, but the idea is to CONTROL the amount of inflammation, not to stop it completely. The ideas behind controling it have been outlined in my eariler post, if the swelling is not reduced then it inhibits the function of the surrounding tissues and can cause them to suffer as well. (Lady Hamilton and I are coming from very similar places it seems which is super encouraging, I may PM you to pick your brain in the future). In which case,, the consumption of anti-inflammatories in the stages of acute inflammtion can indeed help speed recovery simply because it helps to achieve this and also in terms of pain relief. With this in mind Lady Hamilton is indeed talking sense by mentioning the use of NSAIDS after 48hrs to allow this, I can totally see the logic, but here is where I get lost because the application of RICES is indicated in the early stages of acute healing in order to control the inflammation right from the word go. So, how does this work? I'm super confused. Lady Hamilton, can you explain this? Cheers

Clanker

My understanding is that RICE controls the response to the inflammatory mediators rather than supressing their release. This means you get the right chemicals in the right places and enough of a response to kick start the inflammatory process without the excess swelling that, as you rightly mention, causes more tissue damage and limits movement.

However there is little evidence to support the RICE mantra - maybe time will prove this wrong and we'll all be doing something else for acute injuried in a few years time. Meanwhile I shall keep advising RICE as it seems to work!

Clanker

Wow, really? Little evidence to support RICES? Can you give a more scientific explanation of why there is a school of thought suggesting that RICES doesn't work please? Or at least point me in the right direction because that is totally new and I'm really confused now You can PM me if you thik its too dull to go on here, wqould much appreciate it. As far as it not working, well, it does indeed seem to work doesn't it. oh dear